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Here comes the vaccine

Written By: - Date published: 7:00 am, August 21st, 2020 - 46 comments
Categories: australian politics, covid-19, health, jacinda ardern, uncategorized - Tags: ,

Australian Prime Minister Scott Malcom has indicated he’s getting close to the deal of a lifetime for Australians with a letter of intent from Astra Zenica, who are in third stage clinical trials.

Other countries are gearing up for different versions.

But there’s no WHO International Rescue coming.

Instead there’s full-on international non-cooperation and competition.

But a vaccine is appearing on the horizon, and we need to start preparing for a vaccine coming our way, with all the attendant ethical conundrums around it. It’s our one route from this mess towards social and economic stability, but there’s questions to solve:

1. Can The State Make It Compulsory?

No – not here. We have a right under our Bill of Rights (commonly known as BoRA) to refuse medical treatment. So any shot for Covid-19 can’t be made compulsory.

Nothing to worry about you anti-vaxxers.

We New Zealanders have a list of shots called the Immunisation Schedule that you’ll probably recall lining up in Intermediate and High School for, which has been going multiple decades.

Australia doesn’t have a human rights charter, or anything constitutional that would either preclude or enforce compulsory vaccination. I really doubt they’d break the bodily autonomy barrier like that though.

My feeling however is that any employer who does random drug and alcohol testing – that’s anyone in manual labour, or driving anything, or operating machinery – will be tempted to just slip it into the conversation casual-like, rather than on paper, as in “would you like to clean this toilet for the your career here and stay vaccine free, or continue your normal duties?”

Maybe a register of Nons, overseen by the Human Rights Authority or somesuch.

The social force around schools, hospitals, airports, stadiums, and sports clubs will also build up if you choose not to take the cure, shall we say. Social media is going to be one choppy sea of cyberbullying.

So the answer to that question is: who is “we”?

2. Who Will Get It First?

Just as we’ve had consumer fever about toilet paper, and then consumer fever about facemasks, we’ll also get supply fever about the vaccine. For a good few months as it’s rolled out there will be gnashing of teeth as one suburb and then one region appears to get it faster than the other.

Are they going to knock on our door like the tv license van people of old, or like census people used to?

The old? But they’re old. The young? Barely hits them. The middle aged? Smokers? Frontline workers? People in jail? Emergency services staff? Sick people? Community Services Card people? What about those with health insurance – can they jump the queue? Who is “the rest”? And how does that make us all feel? A Lotto draw? Maybe we’ll be all polite like our MMR and Polio shots way back. Or maybe it’s the March of the Undead again.

Where is MedSafe in this? Then where’s Pharmac? How does this allocation system work? Who is in charge of all of this logistical system? Fun times for the health system, particularly if we continue to just make it up and patch it up as we appear to be doing at the border. We’re all having to make this up as we go, stumble, recover, repeat.

The ethics of allocation will be intense as social uproars go, but it will pass.

3. Will It Be Free?

What that means is: will the taxpayer pay, the citizen pay, or a mixed co-payment be the way this is paid for? Nothing is free: even if Astra-Zenica start throwing vials out the back of a truck, there’s big transport and regulatory and standardisation and allocation and administrative costs. For pretty much any medicine in New Zealand, people without special cards part-pay. So then there’s an attendant threshold argument about who is getting what subsidy, and whether that’s all “fair”.

Two days ago Prime Minister Morrison said that if the vaccine succeeded, the Government would manufacture it immediately and make it free for all Australians: “The Oxford vaccine is one of the most advanced in the world, and under this deal we have secured early access for every Australian.” Who knows if we can afford it like that.

My reckons is the first New Zealand political leader to get the word in to Prime Minister Morrison to secure enough for us would score a reasonable political coup. I’m sincerely hoping Prime Minister Morrison isn’t, as the Aussies say, writing cheques with his mouth that his ass can’t cash.

A further ethical question is of course: should you be able to secure your own supply for your own people off Amazon for whatever price, or from Southern Cross by going private, or should it be fully state controlled and doled out at your nearest GP alone? I’d prefer to see us planning for the egalitarian route, but it’s not really enforceable.

4. Should We Wait?

The degree of community infection here remains negligible, and we’ll be back into Level 1 or 2 in no time at all. So surely the people of Brazil or Belgium or the U.K. or India need it a lot more than we do? Why not just see which vaccine is the most effective – just hold off the whole thing for 6 months and see who turns into an Undead?

Some vaccines go wrong. Some vaccine administration goes wrong. It’s rare, but still …

Maybe we’re up for it.

Or maybe we sucked ourselves into believing we’d beaten it and are too bruised to rush to triumph again by jabbing our gut with the first thing thrown at us.

5. And Are We Vaccine-Organised For The Next One?

Should we accelerate the Simpson Report changes to the health system and go even further, as a response to this great thing as bad as the Great Depression, and as confounding? Should and can that be a cross-party agreement on structure and systems, given its social and economic impact?

With the vaccine on the horizon, can we not suck the politics out of this, and get on with arguments about jobs and education and climate and the usual shit? We’ve done it before on stuff like NZSuper, Working For Families, and bunches of other good stuff.

How will we know when we’re strong enough and organised enough to deal with the inevitable variations and next ones? Annual re-shots through work?

Well, we’ve nearly done it with M. Bovis and tuberculosis in tens of millions of cows.

Five million little pricks can’t be too hard.

46 comments on “Here comes the vaccine ”

  1. SPC 1

    Who will get the Oxford vaccine first is already known – India. A company there is producing it while the stage three trial is going on – so they can supply as soon as a positive result occurs.

    Domestically – health sector workers, border bubble workers and those most at health risk would have to head the queue.

  2. roy cartland 2

    Australian Prime Minister Scott Malcom

    Morrison?

  3. xanthe 3

    "Five million little pricks can’t be too hard."

    heh heh…… they certainly can!

  4. greywarshark 4

    We would be grateful for small mercies from Australia, that would be a wise approach to take, provided that we don't then have to sign up to rearm for armaments more than we have already saddled ourselves with.

    We don't want to be reliant on Australia – there be dragons!

  5. barry 5

    The vaccine delivery worldwide will be a clusterfuck like everything else related to the virus.

    The fact that there are many different approaches is good because we will eventually find out which ones work, and the best delivery schedule (how much/how many). However the rush will mean that many ineffective or dangerous concoctions are going to be given out before we get there. It is not until a vaccine is given to millions that we can know.

    Current vaccines (MMR, flu, polio etc) are incredibly safe and effective because the wrinkles have already been ironed out. Side effects are rare, known and manageable. the same will not be sayable for a covid vaccine for at least another year.

    Suffice it to say that I will not be lining up for the first dose. If NZ can keep up our elimination strategy for another year, then I think the world will be ready to deliver a safe vaccine. I presume that we will have done our bit to help, but it will need to be tested in the countries that have the highest incidence (who also have the most to gain).

    So I hope that India gets it, and it helps them to bring the virus under control next year. For NZ it is both selfless and selfish to wait.

    • Tricledrown 5.1

      India has a thriving pharmaceutical industry giving the world cheap generic medicines no doubt they will be able to manufacture enough for everyone.

  6. greywarshark 6

    Those who refuse vaccines under the medical treatment no in the Bill of Rights – if this remains so, then we will not give medical treatment like ventilator time etc to them. They can be helped at a hospice-like facility where because they will be infectious, there will be large glass windows so that family can see them but will converse through a speaker system. Staff will be in full infection cover. No mucking around. These are serious times and we have to face them, if personal wants or beliefs mean people want something individual that is beyond reason then they must follow through to the consequences.

    We absolutely have to both co-operate and respect each other. This method would do both. We should start preparing a separate part of a hospital or hospice as suitable along these lines.

    I see a Northland family asking to travel down to Wellington for a family matter. They want to inter the ashes of a family member and had decided on the anniversary of the death, which is inside the Auckland lockdown. So the whole system that the government has painstakingly set up should be set aside to satisfy their wishes about a date that can easily be changed.

    They set it when things were different, now they have to wait until it is possible. We have spent decades since even before 1984 thinking about being entitled' we have been encouraged to think as individuals, to put ourselves first, to go for what we want. It's destroying the society we had built – it is melting away and our environment and weather going too – it is no longer reasonable to demand something like a child. Time to revert to being responsible adults, if we can persuade enough of us to do so. Even a small minority can bring about further deterioration of our relatively free, co-operative and trusting society.

    • SPC 6.1

      The issue of consent/autonomy has been around a long time.

      Individual rights until the issue of life itself becomes a factor.

      https://www.ima.org.il/FilesUploadPublic/IMAJ/0/44/22002.pdf

    • Aaron 6.2

      @greywarshark that's a pretty vindictive attitude, and a fore taste of what could happen on social media – just like AD was saying.

      It's either a human right to refuse medication or it's not. Rationalising a system of second class service for people who don't conform with your point of view is cruel, no matter how polite the language you use.

      Don't ask for people's respect if you can't respect basic human right.

      • greywarshark 6.2.1

        Oh all the human rights go to the exempting individual do they. What a wet argument that is. Try the other way, the people wanting to stop the spread of an infectious virus have the human right to expect that others will care about them.
        Try that for size. Preach on though if you like to ride round on a high horse.

        • Aaron 6.2.1.1

          Keep up the hard-man talk greywarshark, calling people children, calling my argument wet – Judith Collins would be proud. You proposed a system of health care that effectively punished people who don't take the vaccine. That's a human rights issue and nothing else. Being unkind to people who don't do what you want brings no benefit to the rest of the population, aside from giving some people a feeling of righteous satisfaction that is.

          You wrote: "people wanting to stop the spread of an infectious virus have the human right to expect that others will care about them" but in a situation where the majority of the population is vaccinated there is no mechanism by which the unvaccinated people can make them sick – unless the vaccine is faulty.

          What you are edging toward is a totalitarian approach to solving problems that will create it's own blowback. Unfortunately the pharmaceutical companies will give you lots of support because this vaccine is a potential motherload that will dwarf even their own current profits.

    • georgecom 6.3

      if someone chooses not to get a (effective) covid vaccination when available, more fool them. if they get the virus good luck to them but the rest of us can go about our life in fair security I imagine. those who choose not to get it will not put the populace at risk apart from those who choose not to get vaccinated.

      One consideration is people who for health reasons are unable to get vaccinated but who might otherwise do so, and are therefore at risk from the infectious unvaccinated. then perhaps the infectious should be isolated, some form of compulsory committal or confinement order under a health regulation

      • greywarshark 6.3.1

        I don't understand how people don't understand how infectious Covid-19 is. For goodness sake, we have a comment somewhere here that tells how 90% of Victoria's cases, with I think, over 200 new cases yesterday and 12 deaths, from memory – all came from one family of four!!

        It isn't a benign matter, it can't be brushed off, dear, dear, bad luck, you'll have to lie up for a few weeks won’t you.

        If you know something different to what has been constantly put up for the last months, by all means explain it, otherwise I suggest the old advice of keeping schtum and your eyes open and focussed.

  7. lprent 7

    My understanding is that (at best) this won't be available until the second quarter of next year at the best. They only recently started stage three trials. Those results won't be finalized until the end of the year.

    If they get good results – maybe one chance in twenty. They have to get appovals and manufacture a very large number of doses of what will be a fiddly manufacturing process. And deliver out to the coal face for use. None of these processes will be short. All are fraught with potentials for time loss.

    Personally I can't see any particular reason to get excited by this at present. Useful to look at – yes. But we have more immediate problems to get through before issues about how we stick needles into arms becomes prominent.

    • Gabby 7.1

      Their response to Scotty's marketing spiel seemed a little noncommital, along the lines of it's a letter of intent is all.

    • Draco T Bastard 7.2

      manufacture a very large number of doses of what will be a fiddly manufacturing process.

      That can be helped by spreading it across many manufacturers in many places. That does bring its own headaches of quality control at those locations but it would help in getting a high volume of the vaccine produced quickly.

      • lprent 7.2.1

        That is pretty well what is happening. Plus they're preparing that manufacturing process prior to known the outcomes of the phase 3 trials.

        The Economist did some analysis of the cost/benefit of that and concluded it makes overwhelming sense even though the majority of the preparations for all the different vaccines would probably be a nett waste. The waste from having a covid-19 pandemic raging was far higher.

        "The world is spending nowhere near enough on a coronavirus vaccine (Far better to spend far too much)"

        "Hard questions as scientists and governments seek covid-19 vaccines"

        • RedLogix 7.2.1.1

          NZ has long had the capacity to manufacture world class animal vaccines. I was involved in the automation of one of the largest facilities some years ago; it's high tech and precision work, but it's well within our capacity.

          • greywarshark 7.2.1.1.1

            Is this still operational RL? If so why not put a word in our leaders shell pink ears, or brown ones, and get them thinking about what could be achieved. I don't think that they know everything, and if we have civil servants like the officials that Jeremy Corbyn had, they might not even get told what they need to know.

            • RedLogix 7.2.1.1.1.1

              Yes. It's gone through a number of ownership changes over the years, but it's still running. This particular facility would probably not be directly useful, as it is highly specialised to the production of a specific class of vaccine.

              For COVID it would of course be a lot more efficient to leverage off a world scale unit overseas, but if the politics of the situation required it, then we do have the skills and capacity to build and operate such a plant.

              • greywarshark

                Here in Nelson we have the Cawthron Institute – I suppose there are other laboratories undertaking modern development lab work. Perhaps the government ESR could be the lead movers in this and find suitable entities to do it.

                Perhaps there is some one on weka’s post with ideas.

                Yale does socialist medicine with new covid test

                We might get in on that swab idea with saliva, that would be useful straight away.

                • RedLogix

                  Good point, Cawthron are certainly another one of the significant names. NZ does have a biotech manufacturing sector that's been doing good work for many decades.

                  It's the people with the specific industry skills and experience who are the critical element; if you have those then everything is doable.

                  • greywarshark

                    We could look hard at what we've got in expertise and then it might be a very good case to think about our migrant applications. All over the world there would be jobs for them but they may still like to come to NZ – because we have the special ingredient, gumption! (Scots, possibly from Middle English and Old Norse.) We have found a good supply of it under Labour, and even though immigrants might never have heard the word, they can see what it leads to right here in little NZ.

          • lprent 7.2.1.1.2

            Good point. I keep forgetting that we have a thriving medical industry tending out livestock.

  8. Stuart Munro 8

    I wouldn't count on the Bill of Rights exemptions – quarantine powers are traditionally quite strong, and for fairly good reason.

    A person may be detained for 28 days if the MOoH believes they are infected or pose a risk of infection to the population at large.

    Now, there are many bridges to cross before vaccines become an issue, not least of which is whether they will grant lasting immunity. But assuming the US style rights based objections would triumph over a direction by the MOoH, if one were made, might be optimistic.

  9. Bryan 9

    All of this counting chickens before they are hatched, certainly plan for a vaccine rollout but actually we just have to wait till the successful vaccine candidate/s emerge from phase III trials.

    What ScoMo has secured on the new "vaccine futures" market is a heavily punted option.

    Compulsion will not assist in vaccine uptake – like mask wearing, community consensus, education and understanding – we can all see the consequences around the world of widespread community transmission.

    Already – flu vaccination is normalised and successful, my expectation would be for 70+% uptake -put away the bayonets and handcuffs with refusenik stamped on them.

    • greywarshark 9.1

      Again – this is not flu, Mr Commonsense Sensible.

      • Bryan 9.1.1

        "then we will not give medical treatment like ventilator time etc to them."

        Talk pigshit think pigshit – Nasty is as nasty does.

        Of course it is not flu – but there is an established accepted high uptake mechanism for vaccination against the flu virus.

  10. JPWood 10

    The vaccine could be made compulsory despite what the BORA says, its just that there would be no appetite to pass BORA inconsistent legislation in this case and likely be no need if sufficient numbers took it up.

  11. Chris 11

    "We have a right under our Bill of Rights (commonly known as BoRA) to refuse medical treatment. So any shot for Covid-19 can’t be made compulsory."

    Anything can be made compulsory regardless of NZBORA protections. All that's needed is legislation to be passed. We don't have a system of supreme law in New Zealand.

    • Tabletennis 11.1

      that is what I thought : even article 7 of the UN won't protect you:
      In addition, the idea of informed consent has been universally accepted and now constitutes Article 7 of the United Nations' International Covenant on Civil and Political Rights

      many vaccines are mandatory, (e.g. for attending school,) in Germany, France, Italy the U$ and Australia (to receive welfare).
      IOW a countries bill of rights, doesn't seem to make an iota of difference to bodily autonomy/individual rights.

      They'll (employer/gym/travelling/ etc) put you between a rock and hard place – what? choice, informed consent ? -Bill of rights – don't be silly….
      Furthermore, all those who avoid using products that are tested on animals, (and this vaccine will have been tested on many hundreds of animals including Macau Monkeys and Chimpanzees), are not enough of a market force – what choice? informed consent?

      What's in the end, is the aim of a vaccine: BAU, such that one can continue ignoring climate change, and its devastation on the health of the nation.

  12. greywarshark 12

    Young partying v old shut away, out of sight out of mind.

    https://www.rnz.co.nz/news/national/424084/covid-19-young-people-should-not-bear-brunt-of-blame-for-spreading-virus-expert

    WHO says young people in some countries are spreading disease, gives the impression that it thinks they are feckless.

    The warning, from the World Health Organisation, is based on surges in cases among people in their 20s and 30s in Australia, the Philippines and Japan.

    The entitled, free, libertarian.

    In the US, outbreaks are continuing to emerge in residence halls and fraternity houses, and many spring breakers made it clear that not even a pandemic would hinder their plans to have a good time.
    "If I get corona, I get corona. At the end of the day I'm not going to let it stop me from partying," American Brady Sluder told reporters…

    In the Philippines and Victoria, Australia more than half the cases of Covid-19 in recent weeks have been in people under the age of 40.
    In Japan, two thirds of recent cases are in people aged 39 and under.

    In NZ we are more balanced.

    All the rangatahi RNZ spoke to had real concerns about spreading the virus themselves, but they admit it is a little bit relative.
    "I don't know, I kind of feel like level 2 is low key, like level nothing to some people. It's like – go hard or go home, depending on your outlook," Wellington student, Israel, said.

    Another local, Mark, said: "If I wasn't in New Zealand I'd definitely be freaked out about it. But in New Zealand I'm just concerned."
    And according to an expert, there is nothing wrong with a medium level of caution.

  13. bwaghorn 13

    The roll out should be done on risk factors.

    The old and the Ill then the kids and then cities and lastly us out in the sparsely populated areas.

  14. I notice Scott Morrison would "Make the vaccine free for all Australians"

    Then later "It would be offered to New Zealand and the Pacific as well"

    As a person who has had polio and the effects of that influencing my old age, I am in favour of a successful vaccine.

    The enzyme called Bromelain developed from pineapples used in cancer treatments to stop the spike of covid 19 infecting other cells. Trials in Melbourne next month.

    Someone might be able to put up the article from the NZ Herald. " Pineapples could be key to treating virus" Thanks.

  15. Paaparakauta 15

    Will dual-nationals have to surreptitiously line up outside the Thorndon embassy for a shot ?

  16. Draco T Bastard 16

    My reckons is the first New Zealand political leader to get the word in to Prime Minister Morrison to secure enough for us would score a reasonable political coup.

    I'd be more impressed if we simply made our own deal rather than doing an indirect deal.

    And I'd be more inclined to get a deal that had our pharmaceutical companies manufacture it here as well.

    Why not just see which vaccine is the most effective – just hold off the whole thing for 6 months and see who turns into an Undead?

    That is probably a viable option for us and probably even a good one. We're talking about people's health here and jumping in with both feet is contra-indicated.

    And Are We Vaccine-Organised For The Next One?

    No.

    We don't have anywhere near enough R&D for it which is why we're reliant upon others producing a vaccine for covid. Another failure of the neo-liberal economic hypothesis.

    We should never have become a service and farm economy but an R&D and production economy.

  17. Infused 17

    I'm no anti vaxxer but think I'll be holding off for a bit. This process sounds very rushed

  18. Rosemary McDonald 18

    Probably the right time to have another look at Farah Hancock's piece…

    https://www.newsroom.co.nz/be-prepared-for-covid-19-vaccine-side-effects

    For Oxford University’s vaccine, around 70 percent of participants experienced fatigue, 68 percent had headaches, 60 percent muscle aches, 56 percent chills and 18 percent reported a fever. Symptoms ranged from mild to severe. Trials where participants were asked to take painkillers every six hours the day after the injection showed this reduced some side effects, but often didn’t help the moderate or severe side effects.

    And the Lancet paper on the Oxford Vaccine trials….

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext

  19. Just Is 19

    He isn't called "Scotty from Marketing" for no reason.

    I saw him do the big sell.

    "I've secured 25 million vaccines, enough for everyone, and it will be Free, totally free to every Australian"

  20. McFlock 20

    We should hold off and let places with endemic covid use the vaccines. They need it more than we do.

    This assumes that the vaccines have gone through regular safety trials, unlike the Russian one apparently.

    If the vaccines have significant problems, we have the luxury of being able to keep quarantine and postpone the vaccine, because we're not losing a couple of dozen people a day.

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